Loading rate patterns in scoliotic children during gait: the impact of the schoolbag carriage and the importance of its position

Abstract

Purpose Concerns have been raised regarding the effects of schoolbag carriage on adolescent schoolchildren and particularly those with a pre-existing spinal deformity. The purpose of this study was to determine the effect of school backpack loads in scoliotic and healthy school-age children during walking, in terms of peak vertical ground reaction forces and loading rates. We hypothesized that walking with a loaded backpack would have a greater effect on gait kinetics of scoliotic compared to healthy. Methods Eight children with idiopathic scoliosis and eight healthy children were assessed. Kinetic data were collected using two AMTI OR6-7 force-plates, while the subjects walked freely along a 6-m walkway under three walking conditions: (1) without a schoolbag, (2) carrying a schoolbag bilaterally (over both shoulders-symmetrical load) and (3) carrying a schoolbag unilaterally (over each shoulder-asymmetrical load). Kinetic data were collected and four parameters were calculated; peak ground reaction force at the first maximum force peak (F1), time needed to reach F1 (T1), loading rate of F1 (LRF1) and total contact time (T2). ResultsWe found no significant differences between the scoliotic and healthy children for any of the kinetic variables examined. In addition, the position of the bag did not seem to have any effect on loading rate. Conclusions The results of this study indicate that in terms of kinetic parameters during normal gait, the schoolbag load (symmetrical or asymmetrical) does not have a different effect on children with mild adolescent idiopathic scoliosis compared to normal controls.

Investigation of the Effect of Varied Schoolbag Weight on the Health of Primary Students: A Quantitative Plantar Pressure Study

“…Unele studii [10][11][12][13][14][15] au raportat, de asemenea, cã o presiune plantarã mai mare la nivelul antepiciorului ar putea mãri ºansele de apariþie a deformãrilor de tip varus sau valgus atunci când copiii merg cu ghiozdanul în spate. Meng Zhaoli ºi colab.…”

“…Studies [10][11][12][13][14][15] also reported that a larger plantar pressure loaded on forefoot could cause an increased possibility of varus or valgus deformity when children walked carrying schoolbag. Whereas, Meng Zhaoli et al [10] studied the plantar pressure distribution of school-aged children with different schoolbag weights, and their results implied that the peak pressure under 2nd and 3rd metatarsals increased with 4 kg bags weight bearing whilst normal walking and the center of pressure vibrated a lot in the medial-lateral direction; besides, they also suggested that possibility of varus or valgus deformity was high as the schoolbag weight increased.…”

Effects of Backpacks on Ground Reaction Forces in Children of Different Ages When Walking, Running, and Jumping

“…In this way, high GRFs have been associated with injuries at the spine level [25] and with lower-limb injuries [23], inducing degradation of the biomechanical properties of the joint cartilage. Mechanical forces influence vertebral growth [26], and high loading rates may have negative effects on bone health [27,28]. In this sense, growing children who use backpacks daily may be at risk, especially if they carry an excessive load, which is the norm [29][30][31].…”

The effects of asymmetrical loading on gait characteristics

“…Cottalorda et al [5] reported that no difference was found between carrying a load on one and two shoulders. Symmetrical and asymmetrical school-bag loads did not seem to have any different effect on the gait kinetics of scoliotic children compared to the healthy group in Gelalis et al's study [8]. Pascoe et al [16] and Ozgul et al's [15] studies, however, led to the conclusion that asymmetrical backpack carriage in adolescents biomechanically altered posture and gait parameters.…”